Ng Jeremy Y, Munford Vanessa, Thakar Harmy
Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
BMC Med Inform Decis Mak. 2020 Nov 9;20(1):290. doi: 10.1186/s12911-020-01298-5.
Given an increased global prevalence of complementary and alternative medicine (CAM) use, healthcare providers commonly seek CAM-related health information online. Numerous online resources containing CAM-specific information exist, many of which are readily available/accessible, containing information shareable with their patients. To the authors' knowledge, no study has summarized nor assessed the quality of content contained within these online resources for at least a decade, specifically pertaining to information about adverse effects or interactions.
This study provides summaries of web-based online resources that provide safety information on potential interactions or adverse effects of CAM. Specifically, clinicians are the intended users of these online resources containing patient information which they can then disseminate to their patients. All online resources were assessed for content quality using the validated rating tool, DISCERN.
Of 21 articles identified in our previously published scoping review, 23 online resources were eligible. DISCERN assessments suggests that online resources containing CAM-specific information vary in quality. Summed DISCERN scores had a mean of 56.13 (SD = 10.25) out of 75. Online resources with the highest total DISCERN scores across all questions included Micromedex (68.50), Merck Manual (67.50) and Drugs.com (66.50). Online resources with the lowest total scores included Drug Information (33.00), Caremark Drug Interactions (42.50) and HIV Drug Interactions (43.00). The DISCERN questions that received the highest mean score across all online resources referred to whether the risks were described for each treatment (4.66), whether the aims were clear (4.58), whether the source achieved those aims (4.58), and whether the website referred to areas of uncertainty (4.58). The DISCERN questions that received the lowest mean score across all online resources assessed whether there was discussion about no treatment being used (1.29) and how treatment choices would affect quality of life (2.00).
This study provides a comprehensive list of online resources containing CAM-specific information. Informed by the appraisal of these resources, this study provides a summarized list of high quality, evidence-based, online resources about CAM and CAM-related adverse effects. This list of recommended resources can thereby serve as a useful reference for clinicians, researchers, and patients.
鉴于全球范围内使用补充和替代医学（CAM）的人数有所增加，医疗保健提供者通常会在网上查找与CAM相关的健康信息。存在许多包含特定CAM信息的在线资源，其中许多资源很容易获取，并且包含可与患者共享的信息。据作者所知，至少十年来没有研究总结或评估过这些在线资源中所包含内容的质量，特别是关于不良反应或相互作用的信息。
本研究提供了基于网络的在线资源的总结，这些资源提供了关于CAM潜在相互作用或不良反应的安全信息。具体而言，临床医生是这些包含患者信息的在线资源的目标用户，他们随后可以将这些信息传播给患者。使用经过验证的评分工具DISCERN对所有在线资源的内容质量进行评估。
在我们之前发表的范围综述中确定的21篇文章中，有23个在线资源符合条件。DISCERN评估表明，包含特定CAM信息的在线资源质量参差不齐。DISCERN总分在75分中平均为56.13（标准差=10.25）。在所有问题中DISCERN总分最高的在线资源包括Micromedex（68.50）、默克诊疗手册（67.50）和Drugs.com（66.50）。总分最低的在线资源包括药物信息（33.00）、Caremark药物相互作用（42.50）和HIV药物相互作用（43.00）。在所有在线资源中平均得分最高的DISCERN问题涉及是否描述了每种治疗的风险（4.66）、目标是否明确（4.58）、来源是否实现了这些目标（4.58）以及网站是否提及了不确定性领域（4.58）。在所有在线资源中平均得分最低的DISCERN问题评估了是否讨论了未使用任何治疗的情况（1.29）以及治疗选择将如何影响生活质量（2.00）。
本研究提供了一份包含特定CAM信息的在线资源的综合列表。基于对这些资源的评估，本研究提供了一份关于CAM及与CAM相关不良反应的高质量、循证在线资源的汇总列表。这份推荐资源列表因此可以作为临床医生、研究人员和患者的有用参考。
